Infective endocarditis (IE) is associated with a high degree of morbidity and mortality and generally presents in patients with altered and abnormal heart architecture combined with exposure to bacteria through trauma and other potentially high-risk activities, including body piercing. Modern social behaviour has resulted in increased popularity of the practice of body piercing, particularly amongst the adolescent population and there has been a marked rise of cases of IE directly attributable to this practice. In this article we wish to examine the aetiology of such cases reported in the literature, with particular emphasis on causal organism, as well as to discuss the role of antibiotic prophylaxis and awareness in such at-risk patients within the primary care community.